What’s the Most Effective Way to Screen for Breast Cancer?


My wife and I are preparing for our yearly mammogram; however, we have questions on which type of mammogram to get. Should I just do a regular digital mammogram or is there a more comprehensive or specialized sonogram mammogram?


The main difference between film-screen and digital mammography is the way the photos are produced; film screen mammography uses large sheets of film and digital mammography uses a computer. Both types of mammography accurately detect cancer at about the same rate. The use of digital mammography has some benefits over film-screen mammography including the ability to share the images more easily with clinicians in other locations. This is helpful for women in rural areas or underserved communities.

There’s an additional type of mammography called 3D mammography or digital breast tomosynthesis (tomo). Digital breast tomosynthesis also involves a technologist positioning and compressing your breasts between two plates so an x-ray can be taken, however, the image captured depicts slices of the breast from varying angles. 3D mammograms provide more information than 2D mammograms, but no study has shown that they’re more effective at saving lives. Until recently, if a woman opted to have a 3D mammogram, she would also be required to get a 2D mammogram to accompany it. Combining 3D and 2D mammograms expose the breast to more radiation. In 2016, the FDA approved the first stand-alone screening and diagnostic 3D mammography system. Although approved by the FDA, 3D mammography is not yet recognized as the standard of care for breast cancer screening.

A breast ultrasound is not a good screening tool for breast cancer due to the increased likelihood of false positive and false negative results. Both the National Comprehensive Cancer Network and the American Cancer Society do not recommend breast ultrasound as a stand-alone cancer screening method. In addition, it is not recommended to get a mammogram in combination with a breast ultrasound. More research needs to be done to determine if it is beneficial to have both screening methods. Your doctor might recommend getting a diagnostic ultrasound if you have abnormal mammogram results.

There are pros and cons to each mammography method. When considering which option to use, your doctor can help you determine the best one for you based on your medical history. For more information on mammography screenings, read our fact sheet.

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